周虚中曰∶张景岳有云,太阳血少者,多有戴眼反张之证,俗医称为惊风,误矣。盖太阳经脉,起于目内
,上额,由后颈下背脊,至足小指。凡有血虚不能荣养经络者,一着寒邪,则收引而急缩,理固然也。时
俗不察,往往以豁痰截风之剂,耗其血液,岂不悖哉!此景岳之特见也。
予忆往者,张乃媛,年五六岁,体极瘦削,一日群坐,忽然颠倒,作反弓状,自言楼上有鬼,眼目翻腾,
见白而不见黑。幼科群集,作惊风治不效,已经三日矣。观其人
之骨露筋浮,明系太阳少血,况楼为枯木,鬼属阴邪,亦系寒气伤荣所致。乃遵景岳之言,与道翁先生相商榷,
用厥阴门中当归四逆汤为主,甫投一剂,黑睛稍现,反弓之状亦减,于是连进三服而安。又姻翁高某某乃外家,
冬月拥炉向火,忽然背筋抽引作痛,头足弯后,四肢厥逆,眼皮吊起不能下。亦用前汤,倍加当归,大剂煎服,
一剂而痊。可见先生之力辟惊风,确乎不谬,而太阳之痉,又有血虚体弱之不同也。
痉有刚柔,刚痉无汗,柔痉有汗。小儿刚痉少,柔痉多,而且肌肤薄,腠理疏,不胜发表,惟宜解肌治痉。
当以《金匮》为主,奈《金匮》之方,未敢辄用,而世人亦不能用。今之所选,独海藏五方、《金匮》一方、
杂选一方、附血虚寒袭一方,以为婴儿病痉之准则。其随机应变,又在后贤神而明之,予又何敢以拘?
周虚中说:张景岳曾指出,太阳经血少的人,常出现眼球上翻、身体向后反折的症状,世俗医生称之为“惊风”,这是错误的。因为太阳经脉,起于目内眦,上行至额部,沿后颈部下行至背部脊柱,直至足小趾。凡是因血虚不能濡养经络的,一旦感受寒邪,就会导致经脉收缩拘急,这是理所当然的。当时世俗之人不加考察,往往使用豁痰熄风的药剂,耗伤患者血液,这难道不是违背医理吗!这是张景岳独到的见解。
我回忆过去,张乃媛,五六岁,身体极其消瘦。有一天大家坐在一起,突然跌倒,呈现角弓反张的姿势,自称楼上有鬼,眼睛翻腾,只见白色不见黑色。儿科医生聚集在一起,按惊风治疗无效,已经三天了。观察他的情况,骨露筋浮,明显是太阳经血少;况且楼房是枯木,鬼属阴邪,也都是寒气损伤营血所致。于是遵循张景岳的说法,与道翁先生商量,采用厥阴门中的当归四逆汤为主方,刚投一剂药,黑眼珠稍微显现出来,角弓反张的症状也减轻了,于是连续服用三剂而痊愈。又有一位姻亲高某某,是我的外家亲戚,冬天围着炉火烤火时,突然背部筋脉抽引作痛,头脚向后弯曲,四肢厥冷,眼皮吊起无法落下。也是用前面的方子,加倍加入当归,大剂量煎服,一剂就痊愈了。可见先生极力驳斥“惊风”之说,确实没有错误,而太阳经的痉病,又有血虚体弱的不同情况。
痉病有刚痉和柔痉之分,刚痉无汗,柔痉有汗。小儿患刚痉的少,患柔痉的多,而且肌肤薄,腠理疏松,不耐受发汗解表的方法,只适宜用解肌法治疗痉病。应当以《金匮要略》为主,但《金匮》中的方剂,我不敢轻易使用,世人也未必能用得恰当。现在所选用的,只有李东垣(海藏)的五方、《金匮》一方、杂选一方、以及附带的血虚寒袭太阳病痉方,作为婴儿患痉病的准则。至于随机应变,则在于后世贤才的神妙领悟,我又怎敢拘泥不化?
Zhou Xuzhong stated: Zhang Jingyue once pointed out that individuals with insufficient blood in the Taiyang (Greater Yang) meridian often present with symptoms such as upward deviation of the eyes and opisthotonos (backward arching of the body). Secular physicians erroneously label this condition as "Jingfeng" (Convulsive Disorder). This is incorrect. The Taiyang meridian originates from the inner canthus, ascends to the forehead, descends along the posterior neck to the dorsal spine, and terminates at the little toe of the foot. In cases where blood deficiency fails to nourish the meridians, the invasion of Cold pathogen inevitably causes contraction and spasm of the vessels, which is a natural physiological response. Unaware of this mechanism, common practitioners frequently administer phlegm-resolving and wind-extinguishing formulas, thereby depleting the patient's blood essence. Is this not contrary to medical principles? This represents Zhang Jingyue's unique insight.
I recall a past case involving Zhang Naiyuan, aged five or six, who was extremely emaciated. One day, while sitting with others, she suddenly collapsed into an opisthotonic posture, claiming to see ghosts upstairs. Her eyes were rolling, perceiving only white and not black. Pediatricians gathered and treated her for "Jingfeng" without success for three days. Upon examination, her bones were prominent and tendons were visible, clearly indicating Blood deficiency in the Taiyang meridian. Furthermore, the old building represented dry wood, and ghosts belong to Yin pathogens; thus, the etiology was determined to be Cold damaging the Ying (Nutritive) level. Following Zhang Jingyue’s advice, after consultation with Mr. Daoweng, we prescribed Danggui Sini Tang (Angelica Decoction for Reversal Cold) from the Jueyin (Terminal Yin) chapter as the primary formula. After just one dose, the black pupil became slightly visible, and the opisthotonic posture improved. Three consecutive doses resulted in recovery.
Another case involved my relative-in-law, Gao Moumou. In winter, while warming himself by a stove, he suddenly experienced spasmodic pain in the back muscles, with his head and feet bent backward, cold extremities, and eyelids retracted upward unable to close. We used the same formula, doubling the dosage of Danggui (Radix Angelicae Sinensis), prepared in a large decoction. He recovered after one dose. This demonstrates that Mr. Zhang’s refutation of the "Jingfeng" diagnosis is indeed correct, and that Taiyang Jing (Spasm) presents differently depending on whether there is Blood deficiency and physical weakness.
Jing (Spasm) is categorized into Gang Jing (Rigid Spasm) and Rou Jing (Flexible Spasm). Gang Jing is characterized by absence of sweating, whereas Rou Jing presents with sweating. Children rarely suffer from Gang Jing but frequently from Rou Jing. Given their thin skin and loose cunli (interstices/pores), they cannot tolerate strong diaphoretic methods for releasing the exterior. Therefore, only muscle-relieving methods for treating Jing should be employed. Although the *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) should be the primary reference, its formulas are difficult for me to apply arbitrarily and often misunderstood by the public. Consequently, the selected references herein include Li Dongyuan’s (Haizang) five formulas, one from *Jin Gui*, one miscellaneous selection, and the attached formula for Blood-deficient Cold invading the Taiyang Jing, serving as standards for infantile Jing. As for adapting to changing circumstances, this relies on the profound understanding of later generations; how dare I remain rigid?